Efficacy of intra-articular hypertonic dextrose (Prolotherapy) for knee osteoarthritis: A randomized controlled trial

Regina Wing Shan Sit, Ricky Wing Keung Wu, David Rabago, Kenneth Dean Reeves, Dicken Cheong Chun Chan, Benjamin Hon Kei Yip, Vincent Chi Ho Chung, Samuel Yeung Shan Wong

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


PURPOSE To test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA). METHODS A single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score. The secondary outcomes were the WOMAC composite, function and stiffness scores; objectively assessed physical function test results; visual analogue scale (VAS) for knee pain; and EuroQol-5D score. All outcomes were evaluated at baseline and at 16, 26, and 52 weeks using linear mixed model. RESULTS Randomization produced similar groups. The WOMAC pain score at 52 weeks showed a difference-in-difference estimate of –10.34 (95% CI, –19.20 to –1.49, P = 0.022) points. A similar favorable effect was shown on the differencein-difference estimate on WOMAC function score of –9.55 (95% CI, –17.72 to –1.39, P = 0.022), WOMAC composite score of –9.65 (95% CI, –17.77 to –1.53, P = 0.020), VAS pain intensity score of –10.98 (95% CI, –21.36 to –0.61, P = 0.038), and EuroQol-5D VAS score of 8.64 (95% CI, 1.36 to 5.92, P = 0.020). No adverse events were reported. CONCLUSION Intra-articular dextrose prolotherapy injections reduced pain, improved function and quality of life in patients with KOA compared with blinded saline injections. The procedure is straightforward and safe; the adherence and satisfaction were high.

Original languageEnglish (US)
Pages (from-to)235-242
Number of pages8
JournalAnnals of family medicine
Issue number3
StatePublished - May 1 2020

All Science Journal Classification (ASJC) codes

  • Family Practice


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